Personality Disorders Community

Borderline Personality Disorder in Children

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I am often asked about the BPD (Borderline Personality Disorder) diagnosis in children. By definition, it does not occur since the BPD is defined as developing since early adulthood. Since the problem appears to be primarily in the brain's limbic system, and since the limbic system goes into hyperdrive at puberty, it makes logical sense that the BPD would begin at puberty. While some authors have made their own diagnoses of BPD in children, the literature has not shown consistent findings in this regard - and a study in the 1980's showed that children diagnosed as having BPD in childhood did not have the diagnosis in adulthood.

Many children show symptoms similar to the BPD: inappropriate moodiness, self-destruction, impulsiveness, impulsive aggressiveness, jumping to the wrong conclusions, chronic anger, lack of temper control, irritability, and rejection sensitivity. I've treated many, many children for similar problems, and successful treatment has never included diagnosing the BPD in pre-pubertal children. Attention deficit disorder, depression - especially with psychotic features, what I call "fractured enjoyment" (which is really the formerly diagnosed "depressed personality"), the generalized anxiety disorder, panic disorder, post-traumatic stress disorder, bipolar disorder, and the obsessive compulsive disorders. Bipolar in children is most likely to be confused as "childhood BPD."

Since most of these diagnoses are genetic, I will often have both biological parents do the screening test for themselves and prioritize treating the diagnoses that all three seem to have. This has been a remarkably effective technique, particularly for smaller children.


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